metabolic impact of prospective controlled mediterranean type diets on prostate cancer

Conditions: Prostate Cancer

Summary: the purpose of this study is to examine the impact of mediterranean-type diets on the metabolism of men with localized prostate cancer. the optimal diet for men with a suspected diagnosis of prostate cancer (pca) is currently unknown. more specifically, the suggested benefits of low carbohydrate and low fat diets in pca are not determined.

primary objective -evaluate the impact of mediterranean diets (med-t-diets) on non-malignant prostate tissue metabolism secondary objectives * evaluate the impact of med-t-diets on host metabolism * evaluate the impact of med-t-diets on systemic biomarkers after consuming med-t-diets * evaluate the impact of med-t-diets on the microbiome and dietary behavior and compliance after consuming med-t-diets

Eligibility criteria:
inclusion criteria: * males ≥18 years old * high suspicion of prostate cancer (pca) per urologist's clinical evaluation * bmi \>18.5 * no prior pca diagnosis or hormonal therapy (-ies) * ability to read, write, speak, and understand english * ability to provide informed consent * candidate for and elects active surveillance (as) if diagnostic biopsy is positive * willingness to consume provided dietary interventions * adequate organ and marrow function: white blood cell count (wbc) ≥2,500/mcl, absolute neutrophil count (anc) ≥1,500/mcl, platelets ≥100,000/mcl, hemoglobin ≥9 g/dl (transfusions permitted), total bilirubin ≤1.5 x the institutional upper limit of normal (uln) (for subjects with gilbert's disease ≤3.0 mg/dl), aspartate aminotransferase (ast)/alanine aminotransferase (alt) ≤2.5 x institutional uln, creatinine clearance ≥51 ml/min as defined by cockcroft-gault equation exclusion criteria: * currently consuming a mediterranean, lower carbohydrate, ketogenic, vegan, vegetarian, high fiber diet (14g fiber \> per 1,000 calories) and/or any supplements (including herbal), vitamins, minerals, that would interfere with diets being tested in the study as determined by dietitian and/or investigators. * previous intolerability to fiber-rich diets * colitis, irritable bowel syndrome, or other gastrointestinal condition per clinician discretion * unwilling to undergo transperineal pca biopsies * food allergies or other major dietary restrictions * receiving active medical treatment for type i or type ii diabetes mellitus * prior antibiotic usage (i.e. within last 30 days) at time of consent * recent weight loss (both intentional and unintentional) as defined by 5%+ body weight in the last 30 days * undergone any type of weight loss surgery * any medical contraindications as determined by investigators * high risk as defined by psa≥20 and/or pi-rads 5 lesion as per clinician evaluation * history of diabetic ketoacidosis * gout * patients that are immunosuppressed (transplant history, on immunosuppression, etc.) as per clinician discretion * recent (within last 30 days) device implant/joint requiring antibiotics as per clinician determination * prior history of prostate biopsy infection * uncontrolled hypertension as defined by blood pressure greater than 140/80 (with or without medication) * gallbladder removed or plan to remove per clinician evaluation * other malignancies actively receiving systemic treatment as per clinician evaluation

Keywords: mediterranean-type diets